Feasibility and safety of biventricular repair in neonates with hypoplastic left heart complex

Hypoplastic left heart syndrome is a spectrum of structural cardiac malformations characterized by variable underdevelopment of the left heart-aorta complex. A minority of patients having a milder degree of left ventricular hypoplasia, described as hypoplastic left heart complex (HLHC), may be selected for biventricular repair. The objective of this study was to assess the outcome of the biventricular approach in HLHC. We evaluated retrospectively 30 neonates diagnosed with HLHC from the "12 de Octubre" University Hospital, following established criteria. We analyzed the echocardiographic data recorded just after birth and at last follow-up after surgery. All patients were operated on in the neonatal period using various surgical techniques. There were no early deaths and only 1 late death after a mean follow-up of 62.9 ± 43.8 months. All patients presented a significant growth of the left ventricular structures, with a Z-score increase of 1.17 ± 1.05 for mitral annulus, 1.72 ± 1.23 for aortic annulus, and 1.33 ± 1.46 for left ventricular end-diastolic diameter. Postoperatively, 18 patients showed a left valvular stenosis, and 17 patients underwent a reoperation and/or an interventional procedure. Freedom from surgery or interventional catheterizations at 1, 3 and 5 years was 53, 49 and 43%, respectively. The 29 current survivors are all in a good functional status. In our experience, we achieved good results from biventricular repair in patients with HLHC, with a significant growth of left heart structures and an excellent clinical status at a medium-term follow-up. Nevertheless, there was a high rate of reoperations and/or interventional catheterizations.

Haemorrhagic enteritis associated with herpesvirus in storks

Herpesvirus infection was diagnosed histologically and electron microscopically in white storks (Ciconia ciconia) and abdim storks (Ciconia abdimi). The consistent lesions of herpesvirus infection were haemorrhagic enteritis, with a slight mononuclear cellular infiltrate, dilatation of the crypts lined by a flat epithelium, necrotic foci in the spleen, and focal or scattered coagulative necrosis in the liver without cellular reaction. Intranuclear inclusion bodies were observed in epithelial cells, endothelial cells, lymphocytes, macrophages/monocytes, fibroblasts and smooth muscle cells in digestive tract, spleen, liver, ovary, oviduct and lung. Ultrastructurally, characteristic herpesvirus replication sites were observed in the nuclei of infected cells, with clusters of intracytoplasmic virions and associated structures, intranuclear tubular structures and filamentous aggregates.

[Emergency cesarean in a patient with Coffin-Siris syndrome]

Coffin-Siris syndrome is a rare genetic disease characterized by coarse facial features, sparse scalp hair, hirsutism, hypoplasia of the distal phalanges, hypoplastic nail in the fifth digit, and mental retardation and delayed growth evident in both weight and height. Most cases are sporadic, but the possibility of recessive or dominant autosomal inheritance has been suggested. Facial abnormalities that make intubation difficult and mental retardation that interferes with cooperation are aspects of this disease that can affect the choice of type of anesthesia. We report the case of a parturient with Coffin-Siris syndrome who refused epidural analgesia for labor pain and for whom the obstetrician later decided that an emergency cesarean was necessary due to fetal distress.

Complete sequence of the Pepino mosaic virus RNA genome

We have determined the complete nucleotide sequence (Accession No. AF484251) of the Pepino mosaic virus (PepMV) RNA genome. PepMV is the etiological agent of a new disease which affects tomato crops in Europe and North America. The PepMV genome consists of one single stranded positive sense RNA 6410 nt long that contains five open reading frames (ORFs). ORF 1 is the putative RNA dependent RNA polymerase (RdRp), as it has the characteristic methyltransferase, NTP-binding and polymerase motifs. ORF 2 to 4 form the PepMV triple gene block. ORF 5 codes for the capsid protein. Two short untranslated regions flank the coding regions and there is a poly(A) tail at the 3'end of the genomic RNA. Thus, the genome organization of PepMV is that of a typical member of the genus Potexvirus. The nucleotide sequence obtained shares an overall 99% identity with the genomic RNA of a PepMV isolate from UK which has been partially sequenced. Protein coded by ORF4 is the least conserved between both isolates (95% amino acid identity), whereas proteins coded by ORF3 and ORF5 are identical.

Hematology and clinical chemistry in dystocic and healthy post-reproductive female chameleons

Prevalence of egg-laying disorders and hematology and blood chemical parameters were analyzed in free-ranging common chameleons (Chamaeleo chamaeleon) from southern Spain. During four reproductive seasons oviposition failures occurred only during dry years. Egg binding appeared to be an important cause of mortality. Oviductal eggs of dystocic females were longer and wider than those of females with normal oviposition. Blood cell counts, white blood cell differentials, hematocrit, and concentration of hemoglobin, total plasma protein, glucose, uric acid, aspartate aminotransferase, and creatinine phosphokinase in blood were determined for eight apparently healthy post-reproductive females and considered as reference values. These chameleons differed from other reptiles in high concentrations of glucose in blood, averaging 362 mg/dl, and in high numbers of heterophils. Females with dystocia differed from reference values in an increase in monocytes and in the high concentrations of aspartate aminotransferase probably associated with tissue trauma.

Alpha-2 agonist dissociative anesthetic combinations in fallow deer (Cervus dama)

Three anesthetic protocols, each using an alpha-2 agonist sedative in combination with a dissociative anesthetic, were evaluated in 17 captive fallow deer (Cervus dama). The alpha-2 agonist was given first in two of the three protocols: 1) detomidine (0.1-0.2 mg/kg i.m.) followed by tiletamine-zolazepam (3.0-6.3 mg/kg i.m.) and 2) xylazine (0.6-0.9 mg/kg i.m.) followed by tiletamine-zolazepam (4-5 mg/kg i.m.). In the third protocol, xylazine (1.0-6.2 mg/kg i.m.) and ketamine (2.5-5.1 mg/kg i.m.) were given simultaneously. Each of the sedative/anesthetic combinations produced acceptable immobilization in fallow deer and both provide an alternative to narcotic anesthesia.